Huang Xin, Du Chenfang, Yang Qiong, Fan Dongsheng
Department of Neurology, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Biomarker and Translational Research in Neuro-Degenerative Diseases, Beijing, China.
Front Neurol. 2022 Jun 28;13:938256. doi: 10.3389/fneur.2022.938256. eCollection 2022.
The percent-predicted forced vital capacity (FVC%) in the pulmonary function test (PFT) is generally used to evaluate the respiratory function in amyotrophic lateral sclerosis (ALS). The slow vital capacity (SVC) is another method to evaluate the respiratory function. Some neurologists found that the FVC% was not reflective of respiratory symptoms and the percent-predicted SVC (SVC%) was found to be higher in some patients with bulbar-onset ALS. We aimed to compare the percent predicted SVC (SVC%) with FVC% in evaluating the respiratory function and investigate the associations between the associations between clinical characteristics and the difference between the SVC% and the FVC% (SVC%-FVC%) in bulbar-involved ALS patients.
This prospective study included patients with bulbar-involved ALS who visited the Peking University Third Hospital between October 2020 and November 2021. They underwent comprehensive clinical assessments, including bulbar symptom assessments, revised ALS functional rating scale (ALSFRS-R), Rasch-Built Overall Amyotrophic Lateral Sclerosis Disability Scale (Roads), and PFTs. The group differences were analyzed using parametric and non-parametric tests.
A total of 59 participants were initially enrolled, and 51 of them were included in the final analysis. In patients with bulbar-involved ALS, the SVC% (73.82 ± 21.95%) was significantly higher ( = 0.013) than the FVC% (71.42 ± 23.15%). After controlling for other relevant variables, a partial correlation analysis showed a significant correlation (r = -0.352, = 0.041) between ALSFRS-R1 score and SVC%-FVC%.
Our prospective study found that the SVC% was significantly higher and more reflective of actual respiratory function than the FVC% in patients with bulbar-involved ALS. Furthermore, the severity of dysarthria was found to be positively correlated with SVC%-FVC%, providing a clinical marker for predicting SVC%-FVC%.
肺功能测试（PFT）中预测用力肺活量百分比（FVC%）通常用于评估肌萎缩侧索硬化症（ALS）患者的呼吸功能。慢肺活量（SVC）是评估呼吸功能的另一种方法。一些神经科医生发现FVC%不能反映呼吸症状，并且在一些延髓起病的ALS患者中预测慢肺活量百分比（SVC%）更高。我们旨在比较预测慢肺活量百分比（SVC%）与FVC%在评估呼吸功能方面的差异，并调查延髓受累的ALS患者临床特征与SVC%和FVC%差值（SVC%-FVC%）之间的关联。
这项前瞻性研究纳入了2020年10月至2021年11月期间就诊于北京大学第三医院的延髓受累的ALS患者。他们接受了全面的临床评估，包括延髓症状评估、修订的ALS功能评定量表（ALSFRS-R）、Rasch构建的整体肌萎缩侧索硬化症残疾量表（Roads）以及肺功能测试。采用参数检验和非参数检验分析组间差异。
最初共纳入59名参与者，其中51名被纳入最终分析。在延髓受累的ALS患者中，SVC%（73.82±21.95%）显著高于FVC%（71.42±23.15%）（P = 0.013）。在控制其他相关变量后，偏相关分析显示ALSFRS-R1评分与SVC%-FVC%之间存在显著相关性（r = -0.352，P = 0.041）。
我们的前瞻性研究发现，在延髓受累的ALS患者中，SVC%显著高于FVC%，并且比FVC%更能反映实际呼吸功能。此外，构音障碍的严重程度与SVC%-FVC%呈正相关，为预测SVC%-FVC%提供了一个临床指标。
